VESTIBULAR VEXATION

Athletes get the best concussion care, but most brain injuries happen to ordinary people like me

Concussions are a hotbed of controversy in today’s sports world. In recent weeks, a congressional study found the NFL guilty of influencing concussion research, while two major athletes–wrestling star Sasha Banks and Red Sox infielder Brock Holt–suffered brain trauma from collisions while competing.

Me? I’m a 5-foot-3, 25-year-old management consultant living in New York City, whose most impressive athletic achievement is almost winning a JV tennis match in high school. I could hardly have less in common with these professional jocks. But I too endured a concussion, and like many wounded sports pros, I worried about its impact on my career. While the plight of famous athletic figures has garnered high levels of scrutiny–aided in large part by the 2015 feature film Concussion–the typical head injury patient still enters a medical landscape sapped of resources and attention.

Last October, I smashed my head into my closet doorknob in an accident borne of pure clumsiness. After bending down to retrieve socks, I popped up at exactly the moment my closet door swung ajar. The cracking noise as my skull hit the glass knob shocked me, but I didn’t start bleeding or lose consciousness. Instead, as I pressed my liquid ice pack against my scalp, I experienced nausea, headaches, and the distinct sensation of lucid dreaming.

My boyfriend insisted we visit the emergency room. Walking the Manhattan blocks between my apartment and the hospital, I saw the green metal street signs waver around the edges. The man arranging zucchinis on his produce stand looked like a paper doll. My senses were clearly amiss, but the hospital staff seemed unconcerned. A reassuring nurse gave me a baseline test: I stuck out my tongue, moved my index finger repeatedly between her hand and my nose, and showed off my intact reflexes as she tapped below my knees. Her verdict was that I would recover by nightfall.

I still felt woozy the following morning, but I arrived at my open-plan office determined to make it through the day. I soon found that the glare from my computer monitor intensified my queasiness. My colleagues’ background conversations rushed past my head, settling everywhere but inside my brain. Squinting and disoriented by mid-afternoon, I stopped building the bar graph on my Keynote slide, told my manager about my predicament, and followed her directive to take leave until I healed.

 The man arranging zucchinis on his produce stand looked like a paper doll. My senses were clearly amiss, but the hospital staff seemed unconcerned. Neither of us knew that my rehabilitation would span 2 months. In the beginning, I slept for almost 18 hours a day. In fact, sleeping was one of the only activities I could reliably perform. Reading, looking at screens, or sustaining complex thought were out of the question.

I’d never felt so vulnerable. Unable to express myself, communicating my needs became a tiring chore. Once proud of my self-sufficiency, I now relied on other people to take on my responsibilities. My boyfriend did the bulk of the housework, while my team at work continued their projects with one fewer head. My guilt at not contributing compounded daily.

Assigned to a concussion specialist, I began vestibular therapy to reset my balance. To combat dizziness, I walked up and down a hallway turning my head left and right, then up and down, like an off-kilter wind-up toy. In another session, I put on a pair of goggles that magnified my eyeballs and projected them onto a widescreen. Then I had to collapse my torso onto a cot, while my therapist observed the lag time in my vestibular response.

It was easy for me to see the distress a concussion must cause an athlete, used to pushing their body to the extreme. What I couldn’t understand was why I encountered so few resources on how to deal with brain trauma as an office professional. Surely, among the 1.4 million traumatic brain injuries in the U.S. per year, there were other adult non-athletes overcoming concussions? None of the pamphlets I pulled from the doctor’s office addressed employment concerns; most of the NYU Concussion Center emails I received were geared towards athletes and parents of concussed schoolchildren.

The lack of guidance on navigating employment with post-concussion syndrome left me feeling ill-informed about my prospects. I couldn’t pin down a return-to-work date. My doctor felt confident that I would make a full recovery, but as my symptoms lingered, my doubt escalated.

Fortunately, my practitioner was right: after 2 months I made a full recovery and returned to work with my brain running at pre-concussion speed. Though I’m grateful for the resources I had on my side–a robust healthcare plan, a supportive partner, and the medical talent of a major city–I am concerned on the behalf of those battling similar injuries with fewer advantages. My employer was generous and accommodating, but what if I had worked a different kind of job, one with fewer resources and less understanding colleagues? Would I have lost my position? Would my co-workers’ have retracted their trust in my abilities?

I worry that the most at-risk concussion victims are not professional athletes, but those whose needs are already overlooked: low-wage workers with inflexible jobs, single parents with pressing responsibilities, the elderly, victims of abuse, and working-age women whose illnesses are often downplayed or dismissed. The CDC claims that 40% of traumatic brain injuries are actually caused by falls. By comparison, unintentional blunt trauma of the kind likely to occur on a sports field accounts for 15% of hospitalizations.

Though the media focuses on concussions in the sports world, which indeed deserve attention, the problem is much broader in scope. Most brain trauma patients cannot access care, are misdiagnosed, or find treatment unviable. Only 300,000 of 1+ million victims each year receive treatment. It’s a frightening gap.

Perhaps the contention over how the sports industry handles concussions will catalyze awareness of the injury at-large. If not, it’s important to know that the topic transcends headlines about the NFL. The conversation must broaden to address the needs of many Americans who bear the same brain trauma as professional football players–but with far fewer resources.

We welcome your comments at ideas@qz.com.

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